Meloni Silvio Mario, Jovanovic Sascha A, Urban Istvan, Canullo Luigi, Pisano Milena, Tallarico Marco
Assistant Professor, University of Sassari, Italy.
associated professor, Loma Linda University, CA, USA.
Clin Implant Dent Relat Res. 2017 Feb;19(1):38-45. doi: 10.1111/cid.12429. Epub 2016 Jun 9.
To clinically and radiographically evaluate bone regeneration of severe horizontal bone defects.
This study was designed as a single cohort, prospective clinical trial. Partially or fully edentulous patients, having less then 4 mm of residual horizontal bone width were selected and consecutively treated with resorbable collagen membranes and a 1:1 mixture of particulated anorganic bovine bone and autogenous bone, 7 months before implant placement. Tapered body implants were inserted and loaded 3 to 6 months later with a screw retained crown or bridge. Outcomes were: implant survival rate, any biological and prosthetic complications, horizontal alveolar bone dimensional changes measured on cone beam computed tomography (CBCT) taken at baseline and at implant insertion, peri-implant marginal bone level changes measured on periapical radiographs, plaque index (PI), and bleeding on probing index (BoP).
Eighteen consecutive patients (11 females, 7 males) with a mean age of 56.8 years (range 24-78) and 22 treated sites received 55 regular platform implants. No patient dropped-out and no implants failed during the entire follow-up, resulting in a cumulative implant survival rate of 100%. No prosthetic or biological complications were recorded. Supraimposition of pre- and 7-month post-operative CBCT scans revealed an average horizontal bone gain of 5.03 ± 2.15 mm (95% CI: 4.13-5.92 mm). One year after final prosthesis delivery, mean marginal bone loss was 1.03 ± 0.21 mm (95% CI 0.83-1.17 mm). PI was 11.1% and BoP was 5.6%.
Within the limitation of the present study, high implant survival rate and high average bone augmentation seem to validate the use of collagen resorbable membranes with a 1:1 mixture of particulated anorganic bovine bone and autogenous bone, for the reconstruction of severe horizontal ridge defects.
对严重水平骨缺损的骨再生情况进行临床和影像学评估。
本研究设计为单队列前瞻性临床试验。选取部分或全口无牙且剩余水平骨宽度小于4mm的患者,在种植体植入前7个月,连续使用可吸收胶原膜以及颗粒状无机牛骨与自体骨1:1的混合物进行治疗。3至6个月后植入锥形种植体,并使用螺丝固位的冠或桥进行加载。观察指标包括:种植体存活率、任何生物学和修复并发症、在基线和种植体植入时拍摄的锥形束计算机断层扫描(CBCT)上测量的水平牙槽骨尺寸变化、根尖片上测量的种植体周围边缘骨水平变化、菌斑指数(PI)以及探诊出血指数(BoP)。
18例连续患者(11例女性,7例男性),平均年龄56.8岁(范围24 - 78岁),22个治疗部位共植入55枚常规平台种植体。在整个随访期间无患者退出,无种植体失败,种植体累积存活率为100%。未记录到修复或生物学并发症。术前和术后7个月CBCT扫描叠加显示平均水平骨增量为5.03±2.15mm(95%CI:4.13 - 5.92mm)。最终修复体交付1年后,平均边缘骨吸收为1.03±0.21mm(95%CI 0.83 - 1.17mm)。PI为11.1%,BoP为5.6%。
在本研究的局限性范围内,高种植体存活率和高平均骨增量似乎证实了使用可吸收胶原膜联合颗粒状无机牛骨与自体骨1:1的混合物来重建严重水平牙槽嵴缺损的有效性。